- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02645604
Artemether-lumefantrine Resistance Monitoring in Children With Uncomplicated Plasmodium Falciparum Malaria in Mali
Artemether-Lumefantrine Resistance Monitoring in Children With Uncomplicated Plasmodium Falciparum Malaria in Mali
Background: Malaria is a disease caused by a parasite. People get malaria if they are bitten by an parasite-infected mosquito. A drug called artemether-lumefantrine (AL) can treat malaria. Although iAL has helped make the malaria problem less severe in the African country of Mali, researchers want to find out if malaria parasites are becoming resistant to this drug.
Objective: To test for AL-resistant parasites in children with malaria in Mali.
Eligibility:
AL resistance monitoring study: children aged 2 17 years who live in Kenieroba, Mali, and have malaria.
Blood collection substudy: healthy volunteers aged 18 65 years.
Design:
Volunteers for the substudy will have blood taken up to 6 times a year.
Study participants will be screened with 1 finger-prick blood sample. Girls may have a pregnancy test.
Baseline visit: Participants will have a physical exam. Their vital signs and temperature will be measured. They will answer questions about their symptoms. They will give a blood sample.
Participants will get 6 doses of AL over 3 days. They will take it in tablet form with milk.
Some participants will also stay at the clinic for 2 days. They will have a catheter placed in a vein. They will have blood taken frequently.
Participants will have follow-up visits for about 1 month. They may have:
Physical exam performed
Vital signs and temperature measured
Symptom questionnaire administered
Finger-prick blood sample and/or a regular blood sample taken
Pregnancy test given
Antimalarial medications other than AL provided.
Study Overview
Status
Conditions
Detailed Description
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
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Bamako, Mali
- Malaria Research and Training Center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
- INCLUSION CRITERIA:
Subject Inclusion Criteria: AL Resistance Monitoring Study
- Resident of Kenieroba
- Age 2 to 17 years
- Uncomplicated falciparum malaria, confirmed by the presence of asexual P. falciparum parasites on blood film
- Asexual P. falciparum count between 2,000 and 200,000/ microliters (inclusive) at screening
- Tympanic or axillary temperature greater than or equal to 37.5 (Infinite)C or history of fever in the previous 24 hours
- Written informed consent from the child s parent or guardian, and assent from children aged 14-17 years
Subject Inclusion Criteria: Parasite Clearance Substudy
- Enrolled in the AL Resistance Monitoring Study
- Asexual P. falciparum count greater than or equal to 10,000/ microliters at screening
- Hb level greater than or equal to 7 g/dL
Subject Inclusion Criteria: Blood Collection Study
- Age 18 to 65 years or 5 to 65 years old for the mosquito infectivity study
- Healthy-appearing
- Hb level greater than or equal to 7 g/dL
EXCLUSION CRITERIA:
Subject Exclusion Criteria: AL Efficacy Study
Signs of severe malaria, defined as one or more of the following:
- Blantyre Coma Scale less than or equal to 3/5 in children
- Witnessed convulsions
- Severe prostration
- Shock (poor perfusion, cool peripheries)
- Hb <5 g/dL
- Jaundice
- Respiratory distress (labored breathing, nasal flaring, intercostal retraction)
- Anuria for 24 hours or more
- Repetitive vomiting
- Cessation of eating and drinking
- Acute illness other than uncomplicated falciparum malaria requiring treatment
- Presence of P. ovale or P. malariae parasites on blood film
- Severe malnutrition: http://www.who.int/childgrowth/standards/Technical_report.pdf
- Pregnancy or breastfeeding an infant
- Planning to become pregnant in the next 1 month
- History of taking an ACT in the previous 14 days
- Known hypersensitivity to artemether or LF
- Co-administration of strong inducers of CYP3A4 such as rifampin, carbamazepine, phenytoin, and St. John s wort
- Splenectomy
- Any condition that in the opinion of the investigator would render the patient unable to comply with the protocol (e.g., psychiatric disease)
- Any health condition that in the opinion of the investigator would confound data analysis (e.g., HIV infection) or pose unnecessary exposure risks to the subject
Subject Exclusion Criteria: Parasite Clearance Substudy
-Prior enrollment in the Parasite Clearance Substudy in current transmission season
Subject Exclusion Criteria: Blood Collection Study
- P. falciparum infection, as determined by thick blood smear examination (unless the subject is being screened for inclusion in the mosquito infectivity study, in which case parasitemia, as detected by RDT or smear, is an inclusion criteria)
- History of taking an ACT in the previous 28 days
Study Plan
How is the study designed?
Design Details
- Observational Models: Case-Only
- Time Perspectives: Cross-Sectional
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
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Treatment failure up to Day 28. A subject will be defined as a treatment failure if the subject has developed P. falciparum parasitemia detected by thick blood smear (not by PCR) between the time that parasitemia becomes undetectable and Day 28,...
Time Frame: 28 days
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28 days
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Collaborators and Investigators
Publications and helpful links
General Publications
- Lopera-Mesa TM, Doumbia S, Chiang S, Zeituni AE, Konate DS, Doumbouya M, Keita AS, Stepniewska K, Traore K, Diakite SA, Ndiaye D, Sa JM, Anderson JM, Fay MP, Long CA, Diakite M, Fairhurst RM. Plasmodium falciparum clearance rates in response to artesunate in Malian children with malaria: effect of acquired immunity. J Infect Dis. 2013 Jun 1;207(11):1655-63. doi: 10.1093/infdis/jit082. Epub 2013 Feb 28.
- Ndour PA, Lopera-Mesa TM, Diakite SA, Chiang S, Mouri O, Roussel C, Jaureguiberry S, Biligui S, Kendjo E, Claessens A, Ciceron L, Mazier D, Thellier M, Diakite M, Fairhurst RM, Buffet PA. Plasmodium falciparum clearance is rapid and pitting independent in immune Malian children treated with artesunate for malaria. J Infect Dis. 2015 Jan 15;211(2):290-7. doi: 10.1093/infdis/jiu427. Epub 2014 Sep 2.
- Worldwide Antimalarial Resistance Network (WWARN) AL Dose Impact Study Group. The effect of dose on the antimalarial efficacy of artemether-lumefantrine: a systematic review and pooled analysis of individual patient data. Lancet Infect Dis. 2015 Jun;15(6):692-702. doi: 10.1016/S1473-3099(15)70024-1. Epub 2015 Mar 16. Erratum In: Lancet Infect Dis. 2015 May;15(5):505.
- Petersen JEV, Saelens JW, Freedman E, Turner L, Lavstsen T, Fairhurst RM, Diakité M, Taylor SM. Sickle-trait hemoglobin reduces adhesion to both CD36 and EPCR by Plasmodium falciparum-infected erythrocytes. PLoS Pathog. 2021 Jun 11;17(6):e1009659. doi: 10.1371/journal.ppat.1009659. eCollection 2021 Jun.
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 999916033
- 16-I-N033
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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